Download Partial or Total Thyroidectomy

Robert C Wright, MD, PS– Puyallup, Washington
Informed Consent – Partial/Total Thyroidectomy
We have determined that you have a problem in your thyroid gland requiring its partial or total removal.
The indication for this operation includes goiter, abnormally functioning thyroid nodules, and the
presence or suspicion of cancer in the thyroid gland.
Description of the Procedure
A low collar incision is made in the neck to hide the scar. The muscles surrounding the thyroid
gland are retracted, and the thyroid gland is carefully dissected free of the surrounding structures.
Special care is made to avoid the nerves to the voice box, and to identify and spare the
parathyroid glands, which regulate blood calcium levels. A drain will sometimes be placed and
the neck is closed.
Additional Procedures that may be done while in Surgery
1.
2.
Neck dissection – if a cancer is encountered that has spread to lymph nodes in the neck, we
will usually remove those lymph nodes at the time of the thyroidectomy.
Thoracotomy for intrathoracic thyroid – if the thyroid gland goes deep into the chest and
cannot be removed by a neck incision, the incision will be extended into the chest.
Alternatives for Treatment
Alternative treatments will depend on the nature of the disease undergoing treatment. Cancer requires
surgery for a hope of cure.
Risks/Complications of Treatment
In any medical treatment, it is impossible to predict all the things that could go wrong. Fortunately,
complications are the exception rather than the rule. Every reasonable effort is made to avoid
complications. The most common possible complications are as follows:
Possible complications of major surgery
1.
Bleeding - this is a problem that could happen any time the skin is cut. The need for a blood
transfusion is rare.
2.
Infection – we take special care to prevent an infection , but it is always a possibility. An
infection may require prolonged hospitalization and treatment to resolve.
3.
Reactions to medications – this could be many things, from a minor rash to possible death.
4.
Reactions to anesthesia and surgery – this could show up as a heart attack, blood clots,
pneumonia, sore throat, or potential death in rare cases.
5.
Poor wound healing – breakdown of the incision.
Possible complications of a thyroidectomy
1.
Injury to the recurrent laryngeal nerve or superior laryngeal nerves – injuries to these nerves
may result in variable outcomes, ranging from minor fatigue when talking for lengthy periods
or a change in the voice, to the need for a tracheostomy to permit breathing to occur.
2.
Problems with blood calcium levels – this will result from injury to the parathyroid glands,
which sit against the thyroid gland and regulate serum calcium levels. Correction of this
problem may require short-term or permanent calcium and vitamin D supplementation.
3.
Seroma/hematoma – a collection of fluid beneath the wound. If this happens immediately
after surgery, you may need to be urgently taken back to the operating room.
4.
Recurrence of the cancer – this could occur within the area where the lymph nodes are being
removed, or elsewhere in the body. Cure cannot be guaranteed.
(see other side)
Anticipated Recovery/Expected Rehabilitation
Recovery is quite variable, depending on the individual and the disease being treated. Hospitalization
extends from one to two days. Recovery of full preoperative function usually takes four to six weeks.
Most people can return to light duty in a week. You may drive as soon as you are off of pain medications.
Most people will require lifelong thyroid medications, and this will need to be monitored.
Further treatment of a cancer (should you have one) may be required, including radioactive iodine and
thyroid pills. You may also require further surgery to treat the cancer. The final pathology report
after surgery will influence this decision.
Consent for Treatment
I understand my condition to be a problem with my thyroid and am aware of its risks if untreated.
I have read and understand the above explanation of the procedure being proposed. My surgeon
has answered my questions, and I choose to proceed with surgery.
I understand that every operation may yield unexpected findings. I give the surgeon permission to
act on his best judgment in deciding to remove or biopsy tissues that appear to be diseased,
understanding that complications may arise from that action.
I understand that while most people receiving thyroid surgery benefit from the proposed operation,
I may not. My condition may not improve, and it may worsen. No absolute guarantee can be
made.
HIPAA: Before and after surgery, unless otherwise requested in writing by you, visitors whom you
invite to attend the surgery will be informed of the surgical finding, your surgical status, and
anticipated recovery issues for effectiveness of communications. Because of the anesthetic, you may
or may not remember these important details.
PRINT NAME__________________________________________________________________________
SIGNATURE ______________________________________________ DATE _________________
WITNESS ________________________________________________ DATE _________________
SURGEON ________________________________________________ DATE _________________
RELATIONSHIP TO PATIENT IF SIGNATURE OF LEGAL GUARDIAN ________________________________
I waive the right to read this form, and do not want to be educated and informed of treatment
risks; nonetheless I understand the need for this surgery and grant permission to the surgeon to
proceed on my behalf.
SIGNATURE _____________________________________________________ DATE ______________
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